Universidade Nove de Julho, Postgraduate Program in Rehabilitation Sciences, Physical Therapy Departament, São Paulo, Brazil.
Universidade Estadual de São Paulo, Guaratinguetá, Brazil.
Neurourol Urodyn. 2018 Nov;37(8):2606-2613. doi: 10.1002/nau.23595. Epub 2018 Apr 17.
The aim of this study was to evaluate the reliability of different dynamometric variables of the pelvic floor muscles (PFM) in healthy women during different periods of menstrual cycle.
Vaginal dynamometric equipment was developed by the authors and its reproducibility was tested. The PFM contractions of 20 healthy women were collected by two independent examiners over three consecutive weeks, always on the same day, with a seven-day interval between readings, starting from the first day after the end of the menstrual period. For the measurements, the branch of the dynamometer was positioned first on the sagittal plane and then on the frontal plane. Baseline, peak time, maximum PFM strength, impulse contraction, and average contraction force were calculated. Reproducibility was tested using the intra-class correlation coefficient (ICC) and standard error of measurement. Repeated-measures ANOVA was used to compare the data from different days.
For intra-day and inter-day reliability between examiners, all the parameters collected on the sagittal plane presented good and excellent reproducibility (ICC = 0.60 to 0.98), whereas reproducibility on the frontal plane was respectively poor and excellent (ICC = 0.23 to 0.97). The ANOVA revealed significant differences between sessions only for the impulse of contraction for the sagittal (P = 0.005) and frontal (P = 0.03) planes.
Time and contraction force parameters of the PFM are not influenced by hormonal alterations that occur during the menstrual cycle. The impulse of contraction was the only variable to demonstrate a significant difference between the first and second week of the data collection protocol. The baseline, maximum strength value, impulse of contraction, and average contraction force variables presented good to excellent reproducibility and can be safely used as a method of PFM evaluation.
本研究旨在评估健康女性在不同月经周期阶段时，盆底肌（pelvic floor muscles，PFM）不同测力变量的可靠性。
作者研发了阴道测力设备，并对其可重复性进行了测试。通过两位独立的检查者，在连续三周的时间内，每次检查均间隔七天，共收集 20 名健康女性的 PFM 收缩数据。每次检查均从月经周期结束后的第一天开始，在同一日期进行。测量时，先将测力计的分支定位在矢状面，然后定位在额状面。计算基线、峰值时间、最大 PFM 强度、收缩脉冲、平均收缩力。使用组内相关系数（intra-class correlation coefficient，ICC）和测量标准误差来测试可重复性。采用重复测量方差分析（repeated-measures ANOVA）比较不同日期的数据。
在同一天和不同天的检查者之间，矢状面采集的所有参数均表现出良好到极好的可重复性（ICC = 0.60 至 0.98），而额状面的可重复性分别为较差和极好（ICC = 0.23 至 0.97）。方差分析显示，仅在矢状面（P = 0.005）和额状面（P = 0.03）的收缩脉冲方面，不同测试之间存在显著差异。
在月经周期期间发生的激素变化不会影响 PFM 的时间和收缩力参数。收缩脉冲是唯一在数据收集方案的第一周和第二周之间表现出显著差异的变量。基线、最大强度值、收缩脉冲和平均收缩力变量具有良好到极好的可重复性，可以安全地作为 PFM 评估方法。
